Positive Association between Triglyceride-Rich Lipoprotein Cholesterol and Diabetes Mellitus in Hypertensive Patients

Abstract

Background: The association between triglyceride-rich lipoprotein cholesterol (TRL-C) and diabetes mellitus (DM) remains unclear because of limited research and data. The aim of this study was to explore the independent association between TRL-C and DM in hypertensive patients and to examine whether a healthy lifestyle would have an impact on this relationship.

Methods: In this study, data from 13,721 hypertensive patients who were not treated with lipid-lowering drugs were analyzed. TRL-C was calculated from total cholesterol (TC) minus [LDL cholesterol + HDL cholesterol]. DM was defined as fasting plasma glucose of ≥7.0 mmol/L and/or self-reported history of hypoglycemic drug use.

Results: After adjusting for potential confounding factors, the TRL-C was significantly positively associated with elevated DM (odds ratio (OR): 1.73 and 95% confidence interval (CI): 1.54-1.94). In subgroup analysis, a healthy lifestyle (HL) failed to modify the positive association between TRL-C and DM (HL: OR 1.93, 95%CI 1.58-2.36; non-HL: OR 1.72, 95%CI 1.50-1.98; P for interaction = 0.38).

Conclusion: The results showed a positive association between TRL-C and DM in hypertensive patients. A healthy lifestyle failed to diminish the relationship between TRL-C and DM. The novel findings indicate that TRL-C might be a reliable marker of DM and may provide a new strategy for the prevention and treatment of DM.

Figure 1

Flow chart of study participants.

Figure 2

Dose-response relationship between the TRL-C and the prevalence of DM. Adjusted for age, sex, BMI, current smoking, current drinking, SBP, DBP, eGFR, history of stroke and CAD, and antihypertensive drugs.

Figure 3

Subgroup analyses of the OR (95% CI) of TRL-C on the prevalence of DM. Adjusted for age, sex, BMI, current smoking, current drinking, SBP, DBP, eGFR, history of stroke and CAD, and antihypertensive drugs, if not be stratified.